MEDICARE: ANDREA SANFORD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	22895	NV

General Provider Information

NPI Number	:	1659935294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA SANFORD MD

Provider Business Mailing Address
First Line	:	1664 N VIRGINIA ST # MS 0316
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89557-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 STEAMBOAT PKWY # 150
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89521-6238
Country	:	US
Telephone Number	:	775-800-7494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2019
Last Update Date	:	09/29/2022

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Directions to “ ANDREA SANFORD MD” Practice Location

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